The number of catch-up doses required depends on the age of commencement. Pre-exposure vaccination with rVSVΔG-ZEBOV-GP vaccine is recommended for adults 18 years of age or older in the United States population who are at potential risk of exposure to Ebola virus (species Zaire ebolavirus) because they: Indirect effects on PCV13-type and all-cause pneumonia among adults have also been demonstrated since 2000 (25–27). In 2014, additional reductions in disease incidence among adults aged ≥65 years were expected to occur as a result of ongoing indirect effects of the pediatric PCV13 program, as well as through direct effects of PCV13 use among adults. ¶ Serotype 6C showed cross-protection from 6A antigen in PCV13 and was grouped with PCV13 serotypes for IPD. PCV13. What are the implications for public health practice? PCV13 vaccination is no longer routinely recommended for all adults aged ≥65 years. ACIP continues to recommend PCV13 in series with PPSV23 for adults aged ≥19 years (including those aged ≥65 years) with immunocompromising conditions, CSF leaks, or cochlear implants (Table 1) (2). The recommended age for pneumococcal vaccination for non-Indigenous adults without risk conditions has been changed to 70 years from 65 years of age. Hum Vaccin Immunother 2015;11:2198–206. please contact us for help. Vaccine 2016;34:6330–4. Food and Drug Administration. PCV13 and PPSV23 should not be coadministered. Report all vaccines administered to the Australian Immunisation Register. ** Immunocompetent defined in discussion as adults without an immunocompromising condition (chronic renal failure, nephrotic syndrome, immunodeficiency, iatrogenic immunosuppression, generalized malignancy, human immunodeficiency virus, Hodgkin disease, leukemia, lymphoma, multiple myeloma, solid organ transplants, congenital or acquired asplenia, sickle cell disease, or other hemoglobinopathies), CSF leak, or cochlear implant. In 2014, the estimated cost per QALY for PCV13 use in series with PPSV23 was $65,000 (31). PCV13 uptake among adults aged ≥65 years increased rapidly, with coverage in 2018 estimated at 47%; coverage with any pneumococcal vaccine was 62%, with PPSV23 was 45%, and with both PCV13 and PPSV23 was 30% (23). * Serotype 6C showed cross-protection from 6A antigen in PCV13 and was grouped with PCV13 serotypes for IPD. The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. Gierke R. Estimating impact of 13-valent pneumococcal conjugate vaccine on pneumococcal pneumonia among US adults. Hum Vaccin Immunother 2015;11:172–7. Intervals between PCV13 and PPSV23 vaccines: recommendations of the Advisory Committee on Immunization Practices (ACIP). When patients and vaccine providers§ engage in shared clinical decision-making for PCV13 use to determine whether PCV13 is right for a particular person, considerations might include both the person’s risk for exposure to PCV13 serotypes and their risk for developing pneumococcal disease as a result of underlying medical conditions. CDC will continue to assess the safety, implementation and the impact of shared clinical decision-making regarding administration of PCV13 to adults aged ≥65 years; the indirect effect of pediatric PCV13 vaccination on disease burden among older adults; and the emergence of nonvaccine serotypes, to inform policy decisions for higher valency conjugate vaccines currently in development. 2. CDC recommends routine administration of pneumococcal conjugate vaccine (PCV13) for all children younger than 2 years of age: 1. PPSV23 contains 12 serotypes in common with PCV13 and an additional 11 serotypes for which there are no indirect effects from PCV13 use in children. Balancing this evidence and considering acceptability and feasibility concerns, in June 2019 ACIP voted to no longer routinely recommend PCV13 for all adults aged ≥65 years and instead, to recommend PCV13 based on shared clinical decision-making for adults aged ≥65 years who do not have an immunocompromising condition, CSF leak, or cochlear implant (Table 1) (Table 2). Members of the Advisory Committee on Immunization Practices (member roster for June 2019 is available at https://www.cdc.gov/vaccines/acip/members/index.html). In 2014, PCV13 was recommended for all adults aged ≥65 years (1,5). All authors have completed and submitted the International Committee of Medical Journal Editors form for disclosure of potential conflicts of interest. Pneumovax 23 (pneumococcal vaccine polyvalent). Adverse events following HPV vaccination: 11 years of surveillance in Australia. Lessa FC. Impact of infant 13-valent pneumococcal conjugate vaccine on serotypes in adult pneumonia. All staff must wear a level 1 or type 1 surgical mask (at a minimum) while at work. Early impact of 13-valent pneumococcal conjugate vaccine use on invasive pneumococcal disease among adults with and without underlying medical conditions—United States. Presented at the International Symposium on Pneumococci and Pneumococcal Diseases, Melbourne, Australia; April 15–19, 2018. Durando P, Rosselli R, Cremonesi I, et al. Clin Infect Dis 2018;67:1498–506. This conversion might result in character translation or format errors in the HTML version. Find further information, resources and support on viral hepatitis and liver health. Matanock A. Implementation of a PCV13 recommendation for all adults aged ≥65 years in 2014 has had minimal impact on PCV13-type disease at the population level in this age group. Health and Human Services. Early impact of 13-valent pneumococcal conjugate vaccine use on invasive pneumococcal disease among adults with and without underlying medical conditions—United States. Incidence of PCV13-type invasive pneumococcal disease and pneumonia increases with increasing age and is higher among persons with chronic heart, lung, or liver disease, diabetes, or alcoholism, and those who smoke cigarettes or who have more than one chronic medical condition. Pilishvili T, Gierke R, Xing W, et al. Use of 13-valent pneumococcal conjugate vaccine and 23-valent pneumococcal polysaccharide vaccine among adults aged ≥65 years: recommendations of the Advisory Committee on Immunization Practices (ACIP). In this study, PCV13-types contributed to 4% of all-cause pneumonia among adults aged ≥65 years during 2015–2016 (29) compared with the estimated 10% in 2014 (1). Changes in invasive pneumococcal disease (IPD) among adults following 6 years of 13-valent pneumococcal conjugate vaccine use in the U.S. Impact of introduction of infant vaccination with 13-valent pneumococcal conjugate vaccine (PCV13) on pneumonia and invasive pneumococcal disease (IPD) in the United States, 2005–2014. Of these, 344 did not use PCV13 or did not include an outcome or population of interest. Comparing Medicare data from April 2019 to April 2020, shows a 32 per cent decrease in hepatitis serology tests (mostly hepatitis B and C). It includes: key changes to the pneumococcal vaccination recommendations; and The Vaccine Education Centre at the Children's Hospital of Philadelphia answers common questions related to the development and safety of COVID-19 vaccines. Title and abstract screening yielded 364 studies for in-depth review. Saving Lives, Protecting People, https://www.cdc.gov/vaccines/acip/recs/grade/PCV13.html, https://www.cdc.gov/vaccines/acip/recs/grade/PCV13-etr.html, https://www.cdc.gov/vaccines/acip/members/index.html, https://www.fda.gov/media/107657/download, Centers for Disease Control and Prevention, U.S. Department of Health & Human Services, 1 dose; if PCV13 has been given, then give PPSV23 ≥1 year after PCV13, 1 dose; if PCV13 has been given, then give PPSV23 ≥1 year after PCV13 and ≥5 years after any PPSV23 at age <65 years, 1 dose ≥8 weeks after PCV13 and ≥5 years after any PPSV23 at <65 years, 2 doses, 1st dose ≥8 weeks after PCV13 and 2nd dose ≥5 years after first PPSV23 dose, Sickle cell disease/other hemoglobinopathies, Congenital or acquired immunodeficiencies**, ACIP recommends PCV13 for all adults aged ≥65 years who have not previously received PCV13. Polysaccharide conjugate vaccine against pneumococcal pneumonia in adults. There are no changes to the routine infant schedule for Prevenar 13. N Engl J Med 2015;372:1114–25. PCV13 should be given first, followed by a dose of PPSV23, PCV13 is effective against invasive pneumococcal disease and pneumonia, Low burden of PCV13-type disease remaining, Changing the recommendation could negatively impact the perceived importance of adult pneumococcal vaccine recommendations, Population-level impact from PCV13 use among older adults observed to date has been minimal, Universal recommendations are easier for clinicians to understand and implement than the recommendation based on shared clinical decision-making, Universal PCV13 recommendation for older adults are not a judicious use of resources. Pilishvili T, Almendares O, Xing W, et al. All adults aged ≥65 years should continue to receive 1 dose of PPSV23. Tinoco JC, Juergens C, Ruiz Palacios GM, et al. Incidence of PCV13-type disease has been reduced to historically low levels among adults aged ≥65 years through indirect effects from pediatric PCV13 use. PCV13 effectiveness and safety (individual-level benefits and harms). Effectiveness of pneumococcal vaccines against invasive pneumococcal disease (IPD) among adults >65 years old. In: Vaccine, 22.07.2020. Abbreviations: PCV = pneumococcal conjugate vaccine; PCV7 = 7-valent PCV (serotypes 4, 6B, 9V, 14, 18C, 19F, and 23F); PCV13 = 13 valent PCV (PCV7 serotypes plus 1, 3, 5, 6A, 19A and 7F). The remaining risk is a function of each individual patient’s risk for exposure to PCV13 serotypes and the influence of underlying medical conditions on the patient’s risk for developing pneumococcal disease if exposure occurs. ACIP continues to recommend PCV13 in series with PPSV23 for adults aged ≥19 years with an immunocompromising condition, CSF leak, or cochlear implant (2). There is not enough evidence to routinely support a second dose in the general population at this time, including the elderly and those aged ≥65 years, even if the influenza vaccine was given early in the season. Jackson LA, El Sahly HM, George S, et al. Common reported PCV13-associated adverse reactions included pain, redness, and swelling at the injection site, limitation of movement of the arm in which the injection was given, fatigue, headache, chills, decreased appetite, generalized muscle pain, and joint pain (21). At that time, ACIP recognized that there would be a need to reevaluate this recommendation because it was anticipated that PCV13 use in children would continue to reduce disease burden among adults through reduced carriage and transmission of vaccine serotypes from vaccinated children (i.e., PCV13 indirect effects). This resource provides clinical advice from the Australian Technical Advisory Group on Immunisation (ATAGI) on changes to recommendations for the use and funding of pneumococcal vaccines through the National Immunisation Program (NIP) from 1 July 2020.

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